Self Disclosure and Health Related Quality of Life of Hiv Infected Individuals in Enugu State Nigeria.
ABSTRACT
The purpose of this study was to examine the HIV sero-status disclosure behavior of infected individuals in Enugu State Nigeria and to ascertain whether this is related to their quality of life.
Respondents were adults living with HIV/AIDS who were residing in Enugu State Nigeria and who were recruited through snowball sampling process involving support groups registered with the Enugu State Agency for AIDS Control (ENSACA).
The study had 474 valid responses of which 41.5% are males and 58.5% are females. 39.7% are married, 38.6% are single and only 34% are in full time employment. About 82% of respondents have had at least secondary level education.
Findings show that only 61% of respondents have revealed their diagnosis to someone other than an HIV infected person; and a much smaller proportion (26%) have revealed publicly mainly through public events like World AIDS day, or church worship services (48%), the radio (27%) or the Television (12%).
Furthermore, majority of respondents revealed their status within the first two years of diagnosis with mothers and sisters being the most preferred targets to be entrusted with such intimate information.
Analysis also revealed that disclosure is not affected by sex and income of respondent but by marital status and use of HIV drugs. Disclosing HIV status is also positively associated with better quality of life and mental health of respondents but negatively related to stress perception.
TABLE OF CONTENTS
CERTIFICATION ……….. ii
DEDICATION …….. iii
ACKNOWLEDGEMENT ……….. iv
ABSTRACT ……. v
List of tables ………. vi
List of figures …. viii
Table of Contents ………. ix
List of Acronyms .. xi
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study ……… 1
1.2 Statement of the Problem ….. 2
1.3 Research Questions ……… 5
1.4 Objectives of the study ……. 5
1.5 Significance of the Study ……… 5
1.6 Operationalization of concepts ….. 6
CHAPTER TWO: LITERATURE REVIEW
2.1 Review of empirical literature ……… 9
2.1.1 Disclosure rates……….. 9
2.1.2 Reasons for disclosure and non-disclosure:,…… 10
2.1.3 Targets and timing of disclosure ……. 11
2.1.4 Consequences of disclosure: ………… 13
2.1.5 Factors affecting HRQL of PLWHA … 15
2.2 Review of theoretical literature …… 16
2.2.1 Disease Progression Model ……….. 16
2.2.3 The Competing Consequences Model …. 17
2.2.4 Communication Privacy Management Model….. 19
2.3 Theoretical framework …. 20
2.4 Study Hypotheses … 21
CHAPTER 3: METHODOLOGY
3.1 Study Design .. 22
3.2 Study Area and Population ……. 22
3.3 Sample Size …………… 23
3.4 Sampling Procedure ……. 23
3.5 Instruments and Methods of data collection ……. 24
3.6 Methods of data Analysis …… 25
CHAPTER FOUR: PRESENTATION OF RESEARCH FINDINGS AND ANALYSIS
4.0 Introduction …. 27
4.1 Socio-demographic characteristics of respondents ………… 27
4.2 HIV Disclosure …………… 31
4.3 HIV/AIDS-related Stress Perception …. 40
4.4 Health Related quality of Life ………. 44
4.5 Test of hypotheses ………. 50
4.6 Discussion on findings: ..53
CHAPTER 5: SUMMARY, IMPLICATIONS, CONCLUSION AND RECOMMENDATION
5.1 Summary ……….. 56
5.2 Implications for Social Work …… 56
5.3 Implications for HIV/AIDS Response in Nigeria ….. 58
5.4 Implications for research …. 59
5.5 Conclusion ……… 59
5.6 Limitations….. 60
5.7 Recommendations … 61
REFERENCES …….. 62
APPENDICES …. 68
INTRODUCTION
1.1 Background to the Study
The global HIV/AIDS pandemic has passed the 3rd decade and many of the big issues have changed from what they were in the ‘80s and ‘90s. Fewer people are becoming infected with HIV and fewer people are dying from AIDS (UNAIDS 2010).
The number of people living with HIV globally as at 2007 stood at about 33.4 million and although 2.7 million people became newly infected with HIV in 2007, this represents a decrease of about 17% over the previous eight years (UNAIDS, UNICEF & WHO 2009).
In sub-Saharan Africa, the number of people newly infected with HIV fell from 2.2 million people in 2001 to 1.8 million in 2009 (UNAIDS 2010).
Similarly, the advent of highly active antiretroviral therapy (HAART) and the dramatic increases in international resources to expand HIV treatment coverage and prevention of mother-to-child transmission services in sub-saharan Africa has put more people on the life saving drugs, extended lives for infected individuals and reduced mortality and morbidity (World Health Organization, United Nations Children’s Fund, UNAIDS, 2009).
The increased post infection life expectancy and persistent high level of HIV-related stigma in many parts of the world, including Nigeria, has brought to the fore, the important concerns about HIV diagnosis disclosure and Health related quality of life.
The question of whether to disclose, who to disclose to and how to disclose their diagnosis to others is often a very sensitive matter to the infected individual and a critical matter for HIV prevention and care.
REFERENCES
Akani, C. I. & Erhabor, O. (2006). Rate, Pattern and Barriers of HIV Serostatus Disclosure in a Resource-limited Setting in the Niger delta of Nigeria. Tropical Doctor. 36(2),87-89.
Babcock, J. H. (1998). Involving Family and Significant Others in Acute Care. In D.
Aronstein & B. J. Thompson (Ed.), HIV and Social Work. (pp. 101-108). Binghamton, NY: Harrington.
Batterham, P., Rice E., & Rotheram-Borus, M. (2005). Predictors of serostatus disclosure to partners among young people living with HIV in the Pre- and Post-HAART Eras. AIDS and Behavior, 9(3), (pp 281-287).
Beauregard, C. & Solomon, P. (2005). Understanding the experience of HIV/AIDS for women: implications for occupational therapists. Canadian Journal of occupational therapy. 72(2):113-20
Black, B. P. & Miles, M. S. (2002). Calculating the risks and benefits of disclosure in African American women who have HIV. Journal of Obstetric Gynecologic & Neonatal Nursing, 31:688–697.